EverythingHealth is designed to address the rapid changes in Science, Medicine, Health and Healing in the 21st Century. This site will sift through the vast amount of confusing data and simplify issues that are of interest to everyone interested in a healthy life and longevity. The writings on EverythingHealth are entirely my own views and opinions.

Wednesday, January 23, 2008

Medical Journal Update

Ultrasounds for aortic aneurysms: Abdominal aortic aneurysm ruptures occur suddenly and are almost always fatal. They are about 4 times more common in smokers, than in people who have never smoked. The researchers studied 67,770 men ages 65-74 and found that performing an ultrasound to screen for an enlarged aorta significantly reduced death. Aorta's enlarge slowly until they rupture but do not cause any symptoms. The aneurysm can be surgically removed if found in time. This study showed men over age 65, especially if they have ever smoked, should have screening abdominal ultrasounds. (Women who smoke may also benefit but the study didn't look at the gals.)(Annals Internal Medicine, 2007)

Patients with gastroesophageal reflux disease (GERD) can use PPIs intermittently:GERD is a chronic condition that needs long-term therapy. Most doctors prescribe proton pump inhibitor (PPI) medication for daily ongoing treatment. Researchers compared people who used PPIs daily with patients who took the medication only when their symptoms were acting up. They found PPIs were more effective than placebo and "on- demand" PPIs were more effective than daily maintenance if there were no ulcers. Since PPIs are expensive, this shows that patients who suffer from GERD can take the pills when they feel they need it and don't need to take it every day.(Aliment Pharmacol Ther.,2007)Aspirin reduced the incidence of colorectal cancer:Colorectal cancer is the 2nd most common cancer in developed countries. This study followed healthy men and patients with mild strokes for 23 years. They found aspirin reduced the incidence of colorectal cancer. the effect was seen only after 10 years of follow-up. Because aspirin can cause stomach ulcers ask your doctor if you should take it. (I almost always recommend it to both women and men for cardiovascular protection. Now we have another reason for this cheap, old-fashioned "wonder-drug")(Lancet, 2007)

6 comments:

Anonymous
said...

Almost on a daily basis, one may read about a new medication being developed or approved for the benefit of patients with a particular medical condition or disease state that they exist at the time. At times, these announcements may praise the innovation and novelty of such new drugs that are available to all in need of it, and rightfully so, in many situations.But it’s possible the one particular drug is not new and really may be a super drug. In fact, it’s one of the oldest medications available, and that would be aspirin- the first non-steroidal anti-inflammatory drug (NSAID) initially for those patients experiencing pain.Noted as ASA by doctors typically, aspirin effects have been noted for thousands of years, as the active ingredient comes from the bark of a White Willow tree, and long ago, patients with pain or a fever would chew on this bark for relief. Yet due to the harshness of the natural chemical of this bark, Bayer decided to synthesize it to make it more tolerable for the user.Fast forward to over a hundred years ago and Bayer pharmaceuticals (pronounced ‘Beier’), which is the same company that brought us heroin (named so due to its perceived ‘heroic’ qualities as a believed non-addictive substitute for morphine addicts) and mustard gas, as well as methadone. The company originated in Germany, but presently has its U.S. headquarters in New York. Felix Hoffman, seeking to develop an agent for his father’s rheumatism, was involved in the development of what is known now as aspirin. And it was a difficult task to develop this drug, as it was toxic to the stomach due to the nature of the active ingredient again obtained from the bark of the white willow tree. Dr. Hoffman and others at Bayer developed a drug that proved to be tolerable to patients while keeping the active ingredient in tact through a method of delivery developed by Dr. Hoffman’s team at Bayer. After launching the medication, aspirin was priced at about 50 cents an ounce, as at the time it was only available in power form. Soon before 1920, aspirin developed the tablet form of the drug and was then available by prescription. Regardless, aspirin was responsible for one third of sales for Bayer during this time, due to its popularity due to the effects of this medication in need of relief.While all drugs have side effects, aspirin is one of very few drugs that offers suitable efficacy with perhaps mild side effects associated with the drug, comparatively speaking. Aspirin has been found to be beneficial for a wide variety of disease states. In fact, some of aspirin’s additional uses have been only recently discovered. This may be why the New York Times called aspirin a wonder drug in the 1960s, according to others. In the 1970s, the mechanism of aspirin was isolated, which is the blockage of prostaglandins. Prostaglandins are inside the human body and are a contributor for physiological inflammation.Aspirin has been associated with decreased risk of asthma and prostate cancer in the elderly. Also, aspirin has been linked with lowering the risk of breast cancer and colon cancer as well. Yet these conclusions are based on limited research with aspirin.Aspirin is a blood thinner, and has been associated with decreasing the risk of heart attacks and strokes in certain patient populations, as the drug prevents clots. However, aspirin has not been shown to prevent heart attacks in diabetic patients. The cardiovascular benefits of aspirin were first suggested in the 1940s, and the FDA suggested that it be the drug of choice for those who experienced a heart attack over a decade ago. Aspirin intake is also beneficial for those after coronary bypass procedure. In addition, aspirin has been shown to reduced blood pressure with those who have mild hypertension, if aspirin is taken at night with such patients. A topical formulation of aspirin was developed recently for those experiencing Herpes pain. The drug has been proven beneficial for those experiencing migraine pains. Aspirin at low doses is taken by many as a preventive drug to decrease cardiovascular incidents that may occur.Aspirin has been the best selling painkiller absent of the past addictive qualities of opiate meds since the 1950s. It is also the most studied drug- with over 3000 scientific papers published worldwide. Also, over 15 billion tablets of aspirin are sold annually, which amounts to about 80 million aspirin tablets consumed daily by others. This amounts to over 16,000 tons of aspirin consumed during this time, or about 70,000 metric tons of aspirin a year. Over a decade ago, a study was performed and concluded that twice as many people would choose aspirin over a computer, given the two choices, because of the benefits of the drug. Side effects would include GI bleeding if taken in large amounts, along with an association of Reye’s syndrome in children, yet both are relatively rare. Yet all things considered, clearly the benefits of aspirin outweigh any risks of the drug.Lately, there have been issues with other NSAIDs, such as Cox II inhibitors, without full recollection or knowledge that aspirin is in fact the world’s most widely used drug, and for good reasons. At times, something newer is not always better.Dan Abshear

About Me

I am an Internal Medicine physician who has practiced for over 25 years in Northern California. I was previously the President of the SF Medical Society and Chief of Staff at a large academic medical center. I am currently the Chief Executive Officer for a large Physician and health care provider group in Northern
California. My practice is smaller now
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